Search

AIM: This study aims to identify the key risk factors that lead to subtypes of physical frailty assessed by walking speed and grip strength among community-dwelling Japanese individuals, stratified by the presence of musculoskeletal diseases (MSDs) and age group. METHODS: We included 302 participants aged 70 or 80 years who did not exhibit subtypes of physical frailty at baseline through the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Our study was a longitudinal study. The outcome was the incidence of subtypes of physical frailty after 3 years. Subtypes of physical frailty were defined as a weak grip strength or slow walking speed, or both, based on the Japanese version of the Cardiovascular Health Study Index. The risk factors for subtypes of physical frailty incidence were examined by age group and MSD, using multivariate logistic regressions. RESULTS: Of the 302 participants, 110 (36.4%) had MSD. Those with MSD were significantly more likely to have subtypes of physical frailty after 3 years compared with those without MSD. Among all participants, older age was a risk factor of subtypes of physical frailty (P

The associations among cognitive function, hypertension, and dyslipidemia in older adults are controversial. Therefore, we investigated the associations among cognitive decline, hypertension, dyslipidemia, and their combination in community-dwelling older people in their 70s, 80s, and 90s in the long-term observational Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. We administered the Montreal Cognitive Assessment Japanese version (MoCA-J) by trained geriatricians and psychologists, and conducted blood testing and blood pressure (BP) measuring by medical staff involving 1186 participants. We performed multiple regression analysis to assess the relationships among hypertension, dyslipidemia, their combination, and lipid and BP levels with cognitive function at the 3-year follow-up after adjusting for covariate factors. At the baseline, the percentage of the combination of hypertension and dyslipidemia was 46.6% (n = 553), hypertension was 25.6% (n = 304), dyslipidemia was 15.0% (n = 178), and that without hypertension or dyslipidemia was 12.7% (n = 151). Conducting multiple regression analysis, no significant correlation was found between the combination of hypertension and dyslipidemia and MoCA-J score. In the group with the combination, high high-density lipoprotein cholesterol (HDL) levels resulted in higher MoCA-J scores at the follow-up (β = 0.06; P

Aim: Aging is a major cause of cognitive dysfunction. It has also been reported that respiratory function may influence cognitive dysfunction. However, few studies have examined the relationship between cognitive function and respiratory function among community‐dwelling older adults. This study aims to determine the relationship between respiratory function, assessed using spirometry, and mild cognitive impairment (MCI) in community‐dwelling older adults. Methods: This study included 419 participants aged 73 ± 1 years and 348 participants aged 83 ± 1 years from the SONIC cohort study (Septuagenarians Octogenarians Nonagenarians Investigation with Centenarians Study). Respiratory function was evaluated using %Vital Capacity (%VC), Forced Expiratory Volume 1 s (FEV1)/Forced Vital Capacity (FVC), and %Peak Expiratory Flow (%PEF). Airflow‐limitation presence and stages were classified using FEV1/FVC. Cognitive function and MCI were assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA‐J). Results: The MoCA‐J score exhibited a declining trend as the airflow‐limitation stage increased among study participants in the 83 ± 1 age group. The presence of airflow limitation was associated with MCI in the 83 ± 1 age group. Among the indicators of each respiratory function, low %PEF was found to be associated with an increased rate of MCI. Furthermore, low %VC has also been suggested to be associated with an increased rate of MCI in the 83 ± 1 age female group. Conclusions: Advanced airflow‐limitation stages may exacerbate cognitive dysfunction in community‐dwelling older adults. The presence of airflow limitation and low %VC may also be associated with cognitive dysfunction in older women. Consequently, reduced respiratory function may potentially be associated with MCI in community‐dwelling older adults. Geriatr Gerontol Int 2024; 24: 1001–1007. [ABSTRACT FROM AUTHOR]

Background: A decline in cognitive function is associated with inflammatory processes. However, the association between high-sensitivity C-reactive protein (hs-CRP) levels and cognitive decline in the Japanese population remains inconclusive. Thus, this study aimed to determine whether hs-CRP is associated with low cognitive function in 70- and 80-year-old community-dwelling Japanese individuals. Methods: The participants in this cross-sectional study were 872 Japanese residents aged 70 and 80 years who voluntarily participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study between 2010 and 2011. Blood sample collection, cognitive assessment, and other measurements were performed at the venue. Low cognitive function was defined as a score of 25 points or lower on the Japanese version of the Montreal Cognitive Assessment. The odds ratio (OR) and 95% confidence interval (95% CI) for each hs-CRP quartile were calculated using logistic regression analysis. Results: A total of 288 (69.9%) parsons in the 70-year-old group and 372 (80.9%) in the 80-year-old group exhibited low cognitive function. The association between hs-CRP levels and low cognitive function was significant among 70- and 80-year-old Japanese community-dwelling adults. In particular, the fourth quartile of hs-CRP (0.727–7.420 mg/L) in the 70-year-old group and the second and fourth quartiles (0.214–0.404 and 0.911–9.890 mg/L) in the 80-year-old group were associated with low cognitive function. Furthermore, the third quartile (0.409–0.892 mg/L) in the 80-year-old group was closely associated with low cognitive function. Conclusions: High hs-CRP levels were associated with lower cognitive function in 70- and 80-year-old Japanese community-dwelling individuals, suggesting that high hs-CRP levels may influence cognitive function. [ABSTRACT FROM AUTHOR]

Centenarians have a decreased susceptibility to ageing-associated illnesses, chronic inflammation and infectious diseases.sup.1-3. Here we show that centenarians have a distinct gut microbiome that is enriched in microorganisms that are capable of generating unique secondary bile acids, including various isoforms of lithocholic acid (LCA): iso-, 3-oxo-, allo-, 3-oxoallo- and isoallolithocholic acid. Among these bile acids, the biosynthetic pathway for isoalloLCA had not been described previously. By screening 68 bacterial isolates from the faecal microbiota of a centenarian, we identified Odoribacteraceae strains as effective producers of isoalloLCA both in vitro and in vivo. Furthermore, we found that the enzymes 5[alpha]-reductase (5AR) and 3[beta]-hydroxysteroid dehydrogenase (3[beta]-HSDH) were responsible for the production of isoalloLCA. IsoalloLCA exerted potent antimicrobial effects against Gram-positive (but not Gram-negative) multidrug-resistant pathogens, including Clostridioides difficile and Enterococcus faecium. These findings suggest that the metabolism of specific bile acids may be involved in reducing the risk of infection with pathobionts, thereby potentially contributing to the maintenance of intestinal homeostasis. The microbiota of centenarians (aged 100 years and older) comprise gut microorganisms that are capable of generating unique secondary bile acids, including isoallolithocholic acid, a bile acid with potent antimicrobial effects against Gram-positive--but not Gram-negative--multidrug-resistant pathogens., Author(s): Yuko Sato [sup.1] [sup.2] [sup.3] , Koji Atarashi [sup.1] [sup.2] [sup.3] , Damian R. Plichta [sup.4] , Yasumichi Arai [sup.5] , Satoshi Sasajima [sup.1] [sup.3] , Sean M. Kearney [...]

Context: Fragmentation of care is associated with worse prognosis and higher health care costs in several conditions such as malignancy. Caring for older adults with multimorbidity often requires the involvement of multiple specialists, but the impact of fragmentation of care in older adults with multimorbidity remains unclear. In Japan, the healthcare insurance system guarantees free access, allowing patients to freely see specialists, which can easily lead to fragmentation of care. Objective: To determine how the fragmentation of care is associated with polypharmacy, potentially inappropriate prescribing, and health care costs in older adults. Study Design: An observational cross-sectional study using the baseline survey and claims data of the Cohort study. (The Kawasaki Aging and Wellbeing Project) Setting or Dataset: Community-dwelling people. Population studied: Independent elderly aged 85-89 living in Kawasaki city, Japan. Outcome Measures: The primary outcome was the number of regularly prescribed drugs extracted from claims data. The number of potentially inappropriate drugs for the elderly and the outpatient medical care cost were used as secondary outcomes. Results: There were a total of 1026 study participants, with a 1:1 sex ratio; the mean age was 86.6 years. 650(63.4%) participants regularly visited two or more outpatient clinics. The average number of prescribed drugs was 5.3, and the more clinics a patient visited, the more drugs were prescribed. The odds ratio for polypharmacy, defined as six or more regular prescribed medications, tended to be significantly higher with more visiting clinics, even after adjusted with the number of comorbid chronic illnesses. The number of potentially inappropriate drug prescriptions for the elderly increased with the number of clinics visited. When adjusted for the number of chronic conditions, there was no significant correlation between the fragmentation of care and the number of potentially inappropriate prescriptions. Annual outpatient medical and drug costs were also higher for patients with the fragmentation of care, even when stratified by the number of concomitant chronic conditions. Conclusion: Older adults with the fragmentation of care who regularly visited multiple outpatient clinics correlated with a higher number of prescribed drugs and higher medical costs, even with the same number of chronic conditions., Presenters Takayuki Ando, MD, MPH, Yukiko Abe, BA, Yasumichi Arai, MD, PhD, Takashi Sasaki, Seitaro [...]